Journal of critical care
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Journal of critical care · Oct 2023
Observational StudyApplication of urinary biomarkers for diagnosing acute kidney injury in critically ill patients without baseline renal function data.
Estimating the baseline renal function of patients without prior creatinine measurement is crucial for diagnosing acute kidney injury (AKI). This study aimed to incorporate AKI biomarkers into a new AKI diagnosis rule when no premorbid baseline is available. ⋯ The novel diagnostic rule incorporating serum creatinine and urinary NGAL at ICU admission showed superiority to the MDRD approach in AKI diagnosis without baseline renal function data.
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Journal of critical care · Oct 2023
Malglycemia in the critical care setting. Part I: Defining hyperglycemia in the critical care setting using the glycemic ratio.
Stress-induced hyperglycemia (SIH) is conventionally represented by Blood Glucose (BG) although recent evidence indicates the Glycemic Ratio (GR, quotient of mean BG and estimated preadmission BG) is a superior prognostic marker. We assessed the association between in-hospital mortality and SIH, using BG and GR in an adult medical-surgical ICU. ⋯ Clinically significant SIH commenced above GR 1.1. Mortality was associated with hours of exposure to GR ≥ 1.1 which was a superior marker of SIH compared to BG.
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Journal of critical care · Oct 2023
Review Meta AnalysisNebulized colistin as the adjunctive treatment for ventilator-associated pneumonia: A systematic review and meta-analysis.
Nebulized colistin (NC) is a potential therapy for ventilator-associated pneumonia (VAP); however, the clinical efficacy and safety of NC remain unclear. This study investigated whether NC is an effective therapy for patients with VAP. ⋯ NC was associated with better microbiological outcomes but did not result in any remarkable changes in the prognosis of patients with VAP.
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Journal of critical care · Oct 2023
Review Meta AnalysisFactors associated with acute respiratory distress syndrome in brain-injured patients: A systematic review and meta-analysis.
Acute respiratory distress syndrome (ARDS) is common in patients with acute brain injury admitted to the ICU. We aimed to identify factors associated with ARDS in this population. ⋯ Multiple risk factors are associated with ARDS in brain-injured patients. These findings could be used to develop prognostic models for ARDS or as prognostic enrichment strategies for patient enrolment in future clinical trials.